Solving Homelessness Together in London

London’s Registry Week Volunteer Application

1. Volunteer Information

First Name / Last Name
Address
City / Postal Code
Phone / Email

2. Please mark each survey shift you are able to volunteer

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Early Morning

7:00 am – 9:30 am

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Morning

9:00 am – 12:00 pm

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Afternoon

12:00 pm – 4:00 pm

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Evening

4:00 pm – 8:00 pm

Tuesday, Oct 20

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Not Available

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Orientation/Training

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Wednesday, Oct 21

/ / / /

Thursday, Oct 22

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3. Mandatory Volunteer Orientation and Training

All volunteers must complete one orientation and training workshop. There are two session dates to choose from. Please check the session you plan to attend.

Training is located at Registry Week Headquarters - Dundas Centre United Church, 482 Dundas St

(Dundas and Maitland)

Thursday, October 15, 2015 7:00pm – 9:30pm

(Dundas Centre United Church, 482 Dundas St)

OR

Tuesday, October 20, 2015 9:00am – 11:30pm (Dundas Centre United Church 482 Dundas St)

4. Applicant Signature

-  I am 18 years of age or older

-  I would like to receive information about volunteering during the Point in Time Count

(By February 29, 2016)

I understand that this is an application and that my participation in the events of London’s Registry Week is subject to selection through a screening process. I understand that confirmation that I have been accepted as a volunteer will be provided to me.

______

Signature of Applicant

Please submit a completed copy of this form to:

The personal information collected on this form is collected under the authority of the Municipal Act and will be used in reports to London City Council, interim and final result project reporting to the Canadian Alliance to End Homelessness, information releases to media including newspapers, radio and television, and updates to online websites including the City of London’s website, and social media including Facebook and Twitter. Questions about this collection should be addressed to the Manager of Records and Information Services at 300 Dufferin Ave., London ON N6A 4L9. Telephone: 519 661-2500 ext.5590

Thank you for your interest in volunteering during Registry Week.

For more information please contact the City of London, Homeless Prevention Team at or

519 661-2500 ext. 5729

www.london.ca

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